IRQ Articles

Feature: Millennial IR

A look at how the incoming generation of IRs will impact the field

By Melanie Padgett Powers Spring 2016

Collaborative. Entitled. Optimistic. Lazy. Technology experts. Smartphone-obsessed. These positive and negative generalizations are frequently used to describe the millennial generation, but such words oversimplify its traits.

Millennials are a huge, diverse group in the United States: made up of 83.1 million people, this generation overtook the baby boomers in size in 2015, according to the U.S. Census Bureau. Millennials were born roughly between 1981 and 2000, ranging in age from 16 to 35. In health care, they are the medical students, residents, fellows and early career physicians. How will their upbringing and experiences affect health care and IR?

“Every young generation has been told they’re entitled because, when you’re young, you’re eager, you’re excited, you have so much positive energy, you believe you can do so much and you’re told that you can do so much,” says millennial Hannah Ubl, a generational expert at BridgeWorks consulting firm. “When you come out of college that’s the message that you’re told, right? You’re going to change the world. And so sometimes that can come off as being entitled.”

Unlike previous generations, millennials grew up with a focus on teamwork and group projects. Combine this with their ease of technology, and it’s easy to understand why they’re always connected to each other and default to a collaborative approach. In addition, they are more comfortable questioning superiors.

Raj Pyne, MD, a private practice IR at Rochester General Hospital and medical director of The Vein Institute in Rochester, N.Y., can easily pinpoint the differences between his residents and his partners. At age 37, he belongs to Generation X, which tends to be more independent and follow a strict workplace hierarchy.

“Nothing was questioned when I was training. You read the textbooks, and your attendings’ words were gospel,” Dr. Pyne says. “Now, they learn differently so it’s much more of an interactive and collaborative environment even in terms of teaching because, for better or worse, they question everything. It’s a lot of problem-solving and thinking outside the box.”

Dr. Pyne says his residents already review cases and message each other in groups before they even get to the hospital, having Googled on their smartphones the latest papers and trials regarding the upcoming cases.

“There is, I suppose, an elevated sense of teamwork,” says Kyle Wilson, PhD, age 29, a third-year medical student at the University of Maryland and chair of the SIR Medical Student Council. “I think that’s a good thing—to have a surgeon collaborating with a radiologist collaborating with an internal medicine physician. What we’re starting to see is that the health care system is starting to value outcomes in a way that it hasn’t previously … and we’re finding out we do that much better as a team.”

Work–life balance

A common debate between millennials and older generations concerns work–life balance. “I think sometimes what comes across as [lazy is the desire] to have a flexible work schedule and work anywhere at any time,” Ubl says.

But baby boomers tend to have the mentality that you work long hours, pay your dues, and eventually you’ll reach the top of the hierarchy. Generation Xers often support balance, but they go about it differently, Ubl says. They tend to think, “I’m going to get to work at the time that I’m asked to be there. I will do twice as much work in half the time, and it will be so great and so wonderful that I can then leave and be with my family and my kids,” she says.

However, millennials eschew the traditional hierarchy and work environment, yet embrace merging their professional and private lives. “We really want integration, so it’s like every single part of our lives is integrated,” Ubl says. “We’re always on, and that schedule’s flexible.”

But that can be tricky in health care and certainly bumps up against the demands of Generation X and baby boomer supervisors. Combine those desires with the 80-hour residency work-hour requirements, and you start to see a culture shift, Dr. Pyne says.

“In one way, it’s simply a job for a lot of them, whereas when I trained it was our life. For us, it was and is who we are; for many of them, it’s what they do,” he says. “But at the same time, their work–life balance is admittedly probably better.”

Technology increases connectivity

It’s no secret that technology and smartphones are ubiquitous for most millennials, but this generation’s ease with tech, coupled with the speed of technological advances, could have a profound effect on health care and IR.

Fellows, residents and medical students are connected like no other generation before them, whether it’s texting or via sites like Doximity, a social networking platform for physicians and medical students. The SIR Residents, Fellows and Students Section and the Medical Student Council host their monthly meetings via an online video service. At an American Medical Association House of Delegates meeting last year, the Young Physicians Section used the GroupMe group messaging app to stay connected, prompting the radiology attendings at the meeting to start using it also, according to Laura Traube, MD, MPH, SIR Early Career Section’s young physician representative to the AMA and a millennial interventional and diagnostic radiologist at Santa Barbara Cottage Hospital, California.

Dr. Pyne believes the embrace of both collaboration and technology will lead millennial IRs to establish more patient registries, which will be automated into their electronic medical records (EMRs). “I bet that’s how we get much of our critical patient data in the future,” rather than through only clinical trials, he says.

“They’re going to use this crowd-sourcing knowledge in terms of better patient care,” he says. Instead of knowing a handful of IRs in their city and connecting only once a year at the SIR Annual Scientific Meeting, millennial IRs will be continually connected, updating and communicating with each other as a group.

Technology has also expanded training and continuing education opportunities. Erica Alexander, MD, age 26, a general surgery intern who will be going into radiology at the University of Pennsylvania, has been able to view webinars hosted by the International Association for the Study of Lung Cancer.

“It really puts the experts and leading physicians in the field within reach,” she says. “We’re moving away from medical teaching that’s limited to textbooks or even a simple web search. My generation is really comfortable with things like that.”

Millennial physicians will also likely be more connected to patients online, sending messages back-and-forth through text, email and messaging systems. Dr. Wilson points to a HIPAA-compliant message system at the University of Maryland’s Family Medicine Clinic that allows patients to choose to receive messages via text. This is particularly important for patients who move around a lot or who are living in poverty and often don’t have home Internet access or a computer, he says. “But everybody has a smartphone these days.”

Dr. Wilson is also looking forward to the day when the health care field figures out how to integrate electronic medical records into one system nationwide and incorporate these messaging platforms into it. “That’s a big challenge facing physicians in the future—how to integrate those [EMR] systems so they work the way we always said they would when we implemented them.”

Eric Keller, MA, a medical student and clinical research fellow at Northwestern University, agrees: “The people in my generation do value immediate gratification. We do value being connected a lot more,” he says. “And we’re frustrated with the inefficiencies of EMRs.”

Keller points to EMRs that might list up to 30 prescriptions for a patient, even though that individual may no longer be taking many of those drugs. He looks forward to the creation of more efficient systems and smartphone apps to allow patients to keep track of current medications and update their EMRS and doctors.

The future of IR

As IR develops its own residency program, millennials will be at the forefront, using their technology skills, collaborative nature and desire for work-life balance to shape the specialty.

“I think the millennials’ involvement in IR as a whole is because SIR has really embraced us,” Dr. Alexander says. “It’s nice to be a part of a field that prides itself on growing and advancing and improving technology and patient care.”

Melanie Padgett Powers is a writer/editor in the Washington, D.C., area. She specializes in health writing and has also written for the American Optometric Association, Cleveland Clinic, American College of Ob-Gyns, American Public Health Association and National Hemophilia Foundation.

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